A Symptom Provocation Study of Posttraumatic Stress Disorder Using Positron Emission Tomography and Script-Driven Imagery
Abstract
BACKGROUND: Previous studies have used symptom provocation and positron emission tomography to delineate the brain systems that mediate various anxiety states. Using an analogous approach, the goal of this study was to measure regional cerebral blood flow changes associated with posttraumatic stress disorder (PTSD) symptoms. METHODS: Eight patients with PTSD, screened as physiologically responsive to a script-driven imagery symptom provocation paradigm, were exposed sequentially to audiotaped traumatic and neutral scripts in conjunction with positron emission tomography. Heart rate and subjective measures of emotional state were obtained for each condition. Statistical mapping techniques were used to determine locations of significant brain activation. RESULTS: Increases in normalized blood flow were found for the traumatic as compared with control conditions in right-sided limbic, paralimbic, and visual areas; decreases were found in left inferior frontal and middle temporal cortex. CONCLUSIONS: The results suggest that emotions associated with the PTSD symptomatic state are mediated by the limbic and paralimbic systems within the right hemisphere. Activation of visual cortex may correspond to the visual component of PTSD reexperiencing phenomena.
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Early PET studies reported increased insula activity in response to trauma script-driven imagery in individuals with PTSD, though in some studies no more than in combat-exposed controls.
“early PET studies reported increased insula activity in response to trauma script–driven imagery in individuals with PTSD,24 though in some studies no more than in combat-exposed controls.25”
From Altered resting-state amygdala functional connectivity in men with posttraumatic stress disorder (2012) · cites this paper as [24]
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- Authors
- Rauch, S. L.
- Affiliations
- Harvard University (US)
- Corresponding author
- Rauch, Scott L.
- ORCID
- Rauch, Scott L.
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 1996-05-01
- Volume
- 53
- Issue
- 5
- Pages
- 380
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2031636627
- Semantic Scholar
- 0bfd5b1f356a3b03fd76b7a3f2aa8f7143186072
- Cited by
- 1,056
- References
- 55
- Citations by year
- 2026: 12 · 2025: 47 · 2024: 13 · 2023: 20 · 2022: 23 · 2021: 20 · 2020: 22 · 2019: 29 · 2018: 17 · 2017: 16 · 2016: 36 · 2015: 28 · 2014: 22 · 2013: 25 · 2012: 28
- FWCI
- 52.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k20mh001215-05, 5r01mh048559-02)
- National Institute of Mental Health (MH01215, MH-48559)
- National Cancer Institute (5T32CA09362, T32CA009362)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Keywords
- post-traumatic stress disorder, symptom provocation, script-driven imagery, regional cerebral blood flow, limbic system, paralimbic system, right hemisphere, re-experiencing, visual cortex, emotional state, heart rate
- MeSH terms
- Adult, Brain, Cerebrovascular Circulation, Emotions, Female, Frontal Lobe, Heart Rate, Humans, Imagination, Functional Laterality, Life Change Events, Limbic System, Male, Memory, Middle Aged, Regional Blood Flow, Stress Disorders, Post-Traumatic, Tomography, Emission-Computed, Visual Cortex
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